| 汪昌玉,张 婷,郝 月,何雅星,刘 琴.宫腔镜下冷刀分离术后P8仿生物电刺激辅助治疗宫腔粘连的临床研究[J].,2021,(10):1982-1987 |
| 宫腔镜下冷刀分离术后P8仿生物电刺激辅助治疗宫腔粘连的临床研究 |
| Clinical Study of p8 Biomimetic Electrical Stimulation in Adjuvant Treatment of Intrauterine Adhesions after Hysteroscopic Cold Knife Separation |
| 投稿时间：2021-01-06 修订日期：2021-01-28 |
| DOI：10.13241/j.cnki.pmb.2021.10.039 |
| 中文关键词: 宫腔镜下冷刀分离术 P8仿生物电刺激 宫腔粘连 血流参数 MMP-9 TGF-β1 |
| 英文关键词: Hysteroscopic cold knife separation P8 biomimetic electrical stimulation Intrauterine adhesions Blood flow parameters MMP-9 TGF-β1 |
| 基金项目:福建省医学创新课题项目（2017-CXB-31） |
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| 中文摘要: |
| 摘要 目的：探讨宫腔镜下冷刀分离术后P8仿生物电刺激辅助治疗宫腔粘连的效果及对患者子宫内膜血流参数和血清基质金属蛋白酶-9（MMP-9）、转化生长因子-β1（TGF-β1）水平的影响。方法：选取2017年3月至2019年3月我院收治的宫腔粘连患者106例进行前瞻性随机对照研究，以随机数字表法将患者分为研究组（n=53）和对照组（n=53）。两组均采取宫腔镜下冷刀分离术，对照组术后置入COOK球囊，并在术后当天给予人工周期治疗，研究组在对照组基础上予以P8仿生物电刺激辅助治疗，均治疗3个月。对比两组疗效、月经改善情况、治疗后1年妊娠情况、粘连复发情况和治疗前、治疗1个月后、3个月后粘连评分、子宫内膜容积、子宫内膜厚度、子宫内膜血流参数［阻力指数（RI）、搏动指数（PI）］、血清MMP-9、TGF-β1水平。结果：研究组治疗3个月后总有效率、月经改善率分别为92.45%、94.34%，高于对照组的75.47%、79.25%（P＜0.05）；研究组治疗1个月后、3个月后粘连评分和RI、PI低于对照组，子宫内膜容积、子宫内膜厚度高于对照组（P＜0.05）；研究组治疗1个月后、3个月后血清MMP-9水平高于对照组，TGF-β1水平低于对照组（P＜0.05）；研究组治疗后1年妊娠率44.23%高于对照组25.00%，粘连复发率15.38%低于对照组32.69%（P＜0.05）。结论：宫腔镜下冷刀分离术后P8仿生物电刺激辅助治疗宫腔粘连可减轻宫腔粘连程度，改善子宫内膜容积、厚度、血流情况，调节血清MMP-9、TGF-β1表达，改善月经情况，进而提高疗效和妊娠率，减少粘连复发。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effect of P8 biomimetic electrical stimulation for adjuvant treatment of intrauterine adhesions after hysteroscopic cold knife separation and its influence on endometrial blood flow parameters and the levels of serum matrix metalloproteinase-9 (MMP-9), and transforming growth factor-β1 (TGF-β1). Methods: 106 patients with intrauterine adhesions in our hospital from March 2017 to March 2019 were selected for prospective randomized controlled study. The patients were divided into study group (n=53) and control group (n=53) by random number table. Both groups underwent hysteroscopic cold knife separation. The control group was implanted with a COOK balloon after operation, and was given artificial cycle treatment on the day after operation. The study group was given P8 biomimetic electrical stimulation for adjuvant treatment on the basis of the control group, all of them were treated for 3 months. The efficacy, menstrual improvement, pregnancy status, adhesion recurrence at 1 year after treatment, adhesion score, endometrial volume, endometrial thickness, endometrial blood flow parameters [resistance index (RI), pulse index (PI)], serum MMP-9, TGF-β1 levels before treatment, 1 month after treatment and 3 months after treatment were compared between the two groups. Results: The total effective rate and menstrual improvement rate in the study group at 3 months after treatment were 92.45% and 94.34%, respectively, which were higher than 75.47% and 79.25% in the control group (P<0.05). The adhesion score and RI, PI in the study group were lower than those in the control group at 1 month and 3 months after treatment, and the endometrial volume, endometrial thickness were higher than those in the control group (P<0.05). The level of serum MMP-9 in the study group was higher than that in the control group at 1 month and 3 months after treatment, and the level of TGF-β1 was lower than that in the control group (P＜0.05). The pregnancy rate at 1 year after treatment in the study group was 44.23% higher than 25.00% in the control group, and the adhesion recurrence rate was 15.38% lower than 32.69% in the control group (P<0.05). Conclusion: P8 biomimetic electrical stimulation for adjuvant treatment of intrauterine adhesions after hysteroscopic cold knife separation can reduce the degree of intrauterine adhesions, and improve the volume, thickness and blood flow of the endometrium, regulate the expression of serum MMP-9, TGF-β1, improve menstruation status, and further improve the efficacy and pregnancy rate, and reduce the recurrence of adhesions. |
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